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Preanalytical error

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https://www.readbyqxmd.com/read/28340232/a-proposed-set-of-metrics-to-reduce-patient-safety-risk-from-within-the-anatomic-pathology-laboratory
#1
Peter Banks, Richard Brown, Alex Laslowski, Yvonne Daniels, Phil Branton, John Carpenter, Richard Zarbo, Ramses Forsyth, Yan-Hui Liu, Shane Kohl, Joachim Diebold, Shinobu Masuda, Tim Plummer, Eslie Dennis
Background: Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Method: Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes...
March 18, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28316435/delta-check-for-blood-groups-a-step-ahead-in-blood-safety
#2
Raj Nath Makroo, Aakanksha Bhatia
BACKGROUND: Blood grouping is the single most important test performed by each and every transfusion service. A blood group error has a potential for causing severe life-threatening complications. A number of process strategies have been adopted at various institutions to prevent the occurrence of errors at the time of phlebotomy, pretransfusion testing, and blood administration. A delta check is one such quality control tool that involves the comparison of laboratory test results with results obtained on previous samples from the same patient...
January 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28242283/blood-venous-sample-collection-recommendations-overview-and-a-checklist-to-improve-quality
#3
REVIEW
Davide Giavarina, Giuseppe Lippi
The extra-analytical phases of the total testing process have substantial impact on managed care, as well as an inherent high risk of vulnerability to errors which is often greater than that of the analytical phase. The collection of biological samples is a crucial preanalytical activity. Problems or errors occurring shortly before, or soon after, this preanalytical step may impair sample quality and characteristics, or else modify the final results of testing. The standardization of fasting requirements, rest, patient position and psychological state of the patient are therefore crucial for mitigating the impact of preanalytical variability...
February 25, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28178899/recognizing-and-reducing-analytical-errors-and-sources-of-variation-in-clinical-pathology-data-in-safety-assessment-studies
#4
A E Schultze, A R Irizarry
Veterinary clinical pathologists are well positioned via education and training to assist in investigations of unexpected results or increased variation in clinical pathology data. Errors in testing and unexpected variability in clinical pathology data are sometimes referred to as "laboratory errors." These alterations may occur in the preanalytical, analytical, or postanalytical phases of studies. Most of the errors or variability in clinical pathology data occur in the preanalytical or postanalytical phases...
February 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28164516/hil-interferences-on-three-hemostasis-analyzers-and-contribution-of-a-preanalytical-module-for-routine-coagulation-assays
#5
Carole Nagant, Laurence Rozen, Anne Demulder
BACKGROUND: Preanalytical issues are a major part of routine coagulation laboratory errors. Automation in detection of preanalytical problems, including hemolysis, icterus and lipemia (HIL), improper tube fill volume, and undue clotting, has recently been implemented on specific hemostasis instruments. The aim of this study was to assess the added value of a new preanalytical module integrated into hemostasis analyzers compared to visual inspection of samples. METHODS: The detection of preanalytical issues was performed by visual or manual inspection of the samples and by the new preanalytical module integrated on the ACL TOP 550...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28163015/a-pragmatic-approach-to-sample-acceptance-and-rejection
#6
Janne Cadamuro, Ana-Maria Simundic, Eva Ajzner, Sverre Sandberg
Sample rejection due to preanalytical errors is very common in many medical laboratories worldwide, though the decision when and how to refrain from analyzing such samples is handled very heterogeneously. As a rational, it is mostly stated that it is done to prevent the patient from being harmed by wrong medical decisions based on such values. But when thinking of the consequences of laboratory results instead of their quality being important per se, the rejection of preanalytically altered samples might be harming the patient by the need of re-collection and timely delay...
February 2, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28125403/innovative-software-for-recording-preanalytical-errors-in-accord-with-the-ifcc-quality-indicators
#7
Giuseppe Lippi, Laura Sciacovelli, Ana-Maria Simundic, Mario Plebani
No abstract text is available yet for this article.
March 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28079593/improving-the-clinic-laboratory-interface-in-the-context-of-hiv-diagnosis-treatment-and-monitoring
#8
Timothy Johan Tucker, Peter Tsakani Manyike
PURPOSE OF REVIEW: Laboratory support is central to clinical medicine. The present review focuses on the health systems strengthening needs of the clinic-laboratory-interface (CLI) in developing countries within the context of HIV diagnosis, treatment, and monitoring. RECENT FINDINGS: Although significant improvements have been made in reducing error rates in the analytical phase of pathology services within laboratories, there remain substantial deficits in both the preanalytic and postanalytic phases of the entire value chain that require strengthening...
March 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28069401/analytes-related-to-erythrocyte-metabolism-are-reliable-biomarkers-for-preanalytical-error-due-to-delayed-plasma-processing-in-metabolomics-studies
#9
Mahim Jain, Adam D Kennedy, Sarah H Elsea, Marcus J Miller
BACKGROUND: Delaying plasma separation after phlebotomy (processing delay) can cause perturbations of numerous small molecule analytes. This poses a major challenge to the clinical application of metabolomics analyses. In this study, we further define the analyte changes that occur during processing delays and generate a model for the post hoc detection of this preanalytical error. METHODS: Using an untargeted metabolomics platform we analyzed EDTA-preserved plasma specimens harvested after processing delays lasting from minutes to days...
March 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27917319/the-effectiveness-of-cooling-conditions-on-temperature-of-canine-edta-whole-blood-samples
#10
Karen M Tobias, Leslie Serrano, Xiaocun Sun, Bente Flatland
BACKGROUND: Preanalytic factors such as time and temperature can have significant effects on laboratory test results. For example, ammonium concentration will increase 31% in blood samples stored at room temperature for 30 min before centrifugation. To reduce preanalytic error, blood samples may be placed in precooled tubes and chilled on ice or in ice water baths; however, the effectiveness of these modalities in cooling blood samples has not been formally evaluated. The purpose of this study was to evaluate the effectiveness of various cooling modalities on reducing temperature of EDTA whole blood samples...
2016: PeerJ
https://www.readbyqxmd.com/read/27812302/continuous-quality-control-of-the-blood-sampling-procedure-using-a-structured-observation-scheme
#11
Tine Lindberg Seemann, Mads Nybo
INTRODUCTION: An observational study was conducted using a structured observation scheme to assess compliance with the local phlebotomy guideline, to identify necessary focus items, and to investigate whether adherence to the phlebotomy guideline improved. MATERIALS AND METHODS: The questionnaire from the EFLM Working Group for the Preanalytical Phase was adapted to local procedures. A pilot study of three months duration was conducted. Based on this, corrective actions were implemented and a follow-up study was conducted...
October 15, 2016: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/27812301/blood-gas-testing-and-related-measurements-national-recommendations-on-behalf-of-the-croatian-society-of-medical-biochemistry-and-laboratory-medicine
#12
REVIEW
Lora Dukić, Lara Milevoj Kopčinović, Adrijana Dorotić, Ivana Baršić
Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition...
October 15, 2016: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/27784640/preanalytics-in-urinalysis
#13
REVIEW
Joris R Delanghe, Marijn M Speeckaert
Urine contains an enormous amount of information. Well-standardized procedures for collection, transport, sample preparation and analysis should become the basis of an effective diagnostic strategy for urinalysis. As reproducibility of urinalysis has been greatly improved due to recent technological progress, preanalytical requirements of urinalysis have gained importance and have become stricter. Since the patients themselves often collect urine specimens, urinalysis is very susceptible to preanalytical issues...
December 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27771343/re-engineering-laboratory-diagnostics-for-preventing-preanalytical-errors
#14
EDITORIAL
Giuseppe Lippi, Raffick Bowen, Dorothy M Adcock
No abstract text is available yet for this article.
December 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27720280/preanalytical-considerations-for-joint-fluid-evaluation
#15
REVIEW
Caitlyn R Martinez, Kelly S Santangelo
Synovial fluid analysis is a key component of the minimum database needed to diagnose and manage primary and secondary articular joint disorders. Unfortunately, preanalytical variables can drastically alter samples submitted for evaluation to veterinary laboratories and it is considered the stage at which most laboratory error occurs. This article addresses common sources of preanalytical variability and error that are seen in veterinary medicine. With consistent quality control and reporting of specimens, downstream clinical decision making and management of patients can be accelerated and improved...
January 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27717415/monitoring-oxygen-status
#16
REVIEW
J G Toffaletti, C R Rackley
Although part of a common "blood gas" test panel with pH and pCO2, the pO2, %O2Hb, and related parameters are independently used to detect and monitor oxygen deficits from a variety of causes. Measurement of blood gases and cooximetry may be done by laboratory analyzers, point of care testing, noninvasive pulse oximetry, and transcutaneous blood gases. The specimen type and mode of monitoring oxygenation that are chosen may be based on a combination of urgency, practicality, clinical need, and therapeutic objectives...
2016: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/27686172/significant-reduction-in-preanalytical-errors-for-nonphlebotomy-blood-draws-after-implementation-of-a-novel-integrated-specimen-collection-module
#17
Rachel D Le, Stacy E F Melanson, Athena K Petrides, Ellen M Goonan, Ida Bixho, Adam B Landman, Anne Marie Brogan, David W Bates, Milenko J Tanasijevic
OBJECTIVES: Most preanalytical errors at our institution occur during nonphlebotomy blood draws. We implemented an electronic health record (EHR), interfaced the EHR to the laboratory information system, and designed a new specimen collection module. We studied the effects of the new system on nonphlebotomy preanalytical errors. METHODS: We used an electronic database of preanalytical errors and calculated the number and type of the most common errors in the emergency department (ED) and inpatient nursing for 3-month periods before (August-October 2014) and after (August-October 2015) implementation...
October 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27645817/critical-care-glucose-point-of-care-testing
#18
S N Narla, M Jones, K L Hermayer, Y Zhu
Maintaining blood glucose concentration within an acceptable range is a goal for patients with diabetes mellitus. Point-of-care glucose meters initially designed for home self-monitoring in patients with diabetes have been widely used in the hospital settings because of ease of use and quick reporting of blood glucose information. They are not only utilized for the general inpatient population but also for critically ill patients. Many factors affect the accuracy of point-of-care glucose testing, particularly in critical care settings...
2016: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/27592325/freedom-solo-associated-thrombocytopaenia-is-valve-dependent-and-not-due-to-in-vitro-pseudothrombocytopaenia
#19
Olaf Stanger, Brigitta Gahl, Michael Grabherr, Richard Krausler, Sarah Longnus, Andreas Meinitzer, Janne Cadamuro
BACKGROUND: Use of the Freedom SOLO (FS) stentless aortic bioprosthesis is limited by a unique and as yet unexplained severe decrease in postoperative platelet count in the absence of FS-related excess bleeding or thromboembolism. We investigated whether anticoagulant-associated pseudothrombocytopaenia could explain this complication. METHODS: Thirty consecutive patients (mean age 75.4±7.7 years, 11 [36.7%] female) underwent elective aortic valve replacement (AVR) with either the stented bovine Mitroflow (MF, n=18) or the stentless bovine FS (n=12) aortic valve bioprostheses...
August 16, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27580180/risk-analysis-of-the-preanalytical-process-based-on-quality-indicators-data
#20
Zlata Flegar-Meštrić, Sonja Perkov, Andrea Radeljak, Mirjana Marijana Kardum Paro, Ingrid Prkačin, Ana Devčić-Jeras
BACKGROUND: Improving quality and patient safety in the medical biochemistry laboratory accredited according to the International Standard Organization (ISO 15189:2012) requires the patient-centered evaluation of errors based on the implementation of quality indicators (QIs) across the total testing process. Our main goal was to achieve quality improvement of the preanalytical process in an emergency laboratory which had the highest error rate using risk management principles. METHODS: Failure mode and effects analysis (FMEA) was applied to analyze predefined preanalytical QIs and score laboratory failures for the failure demerit value (FDV), probability of failure (PF) and probability of failure remedy (PFR)...
March 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
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